By Robert C. Broschart
There are approximately 600,000 ultrasound probes in service in the United States alone, and fewer than 25% of those probes are properly tested or repaired. That means that patients are unnecessarily put at risk every day. It has been shown that about one out of every four probes in clinical use has some type of physical defect or performance problem needing to be resolved.1 If those defects are discovered early enough, 75% of the defective probes can be repaired. And repairing a probe, rather than replacing it, can result in cost savings versus replacement of as much as 60% to 70%.
Four Keys to Lowering Costs
The key to controlling the cost of probe repairs is early detection by regularly inspecting your probes and resolving the problems as soon as they are found. Here are some proactive measures you can take to ensure that your probes are operating at optimal performance.
Make sure all probes that go through any sort of disinfection process are being cleaned properly and according to manufacturer’s specifications. Sterilizing TEE, intercavity, and other probes properly not only extends the life of the probe by preventing buildup of debris on the lens, but also prevents contamination of patients and the spread of diseases like Legionella pneumophila. However, excessive cleaning is the root cause of many probe problems, especially with TEE and intercavity probes.
Many people assume that the longer you sterilize, the better. That’s simply not true. Soaking probes in disinfectant too long will cause excessive wear and damage to the insertion tube on TEE probes and the probe housing on intercavity probes. In addition, no disinfecting solution or rinsing water should be allowed beyond the end of the insertion tube or the connector end of any probe, since the fluids can potentially get into the probe or connector, causing failure. Proper cleaning starts with thorough review of OEM specifications.
Train your sonographers to look for minor problems with their probes regularly. Teach all technicians to visually inspect probes regularly and note any physical defects, such as cracks, cuts, holes, and the like in lenses, cables, and strain reliefs. Cracks, holes, and cuts allow fluids, such as gel, disinfectants, or even body fluids, to infiltrate the probe. When fluid comes in contact with internal electrical and mechanical assemblies, it can short-circuit PCB boards, cause corrosion, and damage crystal arrays.
Fluid infiltration is the biggest killer of probes, often destroying them from within. These cracks and holes also allow the potential for cross-contamination, putting your patients and your facility at risk. Minor problems like these are usually repairable, but if left unattended, they will lead to failure and costly replacement.
Cost reduction can be achieved with good preventive maintenance procedures for all your ultrasound probes. Remember, a lens can be repaired for a few hundred dollars. A new array can cost a few thousand. As defects are discovered, make arrangements to have the probe evaluated for possible repair. Identifying and resolving these defects early can lower your risks, prevent more costly repairs or replacements, and save tens or even hundreds of thousands of dollars annually.
Test at least every 6 months. Dead elements can and do cause improper clinical outcomes. Even two or three dead elements adjacent to one another will cause false Doppler readings. This situation can have dire consequences for the patient and result in costly repairs for your facility. Therefore, use common sense and make sure your probes are always clinically usable. Be sure to test them at least twice a year. And remember: Always consider how delicate the probes truly are and handle with caution and care.
Create an optimal environment in the lab. The new single-crystal array probes are very sensitive to extreme temperatures. Make sure the environment of your lab is optimal for the probe by maintaining a consistent ambient temperature and humidity (72ºF and 30% to 40% relative humidity is ideal).
Remember, the probe is the only part of the ultrasound system that touches the patient, producing an interface between the patient’s anatomy and the ultrasound system. As such, the device serves as a data transfer tool, providing critical information to diagnose and treat a patient. If the probe is not 100% clinically effective, then the diagnosis will not be 100% accurate. Taking simple, easy steps to care for probes will help to ensure your probes are always clinically effective and that patients are not at risk.
As ultrasound probe technology rapidly evolves, preventive maintenance and repairs are becoming more complex and costly. Considering that upward of 70% of all ultrasound service calls are probe related, it pays to prevent probe damage to minimize patient risks, and also realize the added bonus of lower costs. 24×7 October 2013
1. Weigang B, Moore GW, Gessert J, Phillips WH, Schafer M. The method and effects of transducer degradation on image quality and the clinical ef?cacy of diagnostic sonography. J Diagn Med Sonog. 2002;19:3-13.